It's Time To Normalize Medical Marijuana In Pro Sports

Steve Kerr has a bad back. The condition caused him so much physical pain that Kerr, the current head coach of the Golden State Warriors and a member of five NBA championship teams during his playing career, underwent surgery to resolve it. Complications and recovery from the procedure led to him missing the first half of the 2015-2016 regular season. He was in enough pain that he took marijuana to relieve the pain. And that has him a bit crosswise with some people in the NBA, which frowns on any use of marijuana.

Kerr revealed his drug use during a recent podcast interview with Comcast SportsNet California. He went so far as advocating that the NBA's next Collective Bargaining Agreement include a provision that would permit players to use marijuana for medical purposes. He is right. It is time to rethink prohibitions on the use of marijuana in sports.

Golden State Warriors coach Steve Kerr reacts during the team's NBA basketball game against the San Antonio Spurs in Oakland, California, on October 25, 2016. Kerr, the reigning NBA Coach of the Year, acknowledged he tried marijuana twice in the past 18 months while dealing with debilitating back pain. Kerr told Comcast SportsNet Bay Area's Warriors Insider Podcast with Monte Poole on Friday, December 2, that he used medicinal marijuana but it didn't help. (Photo credit: Ben Margot/AP)

For starters, let's get a few things clear about where Kerr is coming from when the subject is reefer. First, there is a fine line between using marijuana medicinally and using it recreationally. Second, medical marijuana is an alternative to using commonly-prescribed, highly-addictive, opiate-based pain medications such as Vicodin and Oxycontin, which have turned many athletes, including NFL quarterbacks Ryan Leaf and Brett Favre, into addicts. Third, there is a changing social, political, and medical landscape in the U.S. around the use of medical marijuana to manage pain associated with chronic injuries and illnesses, as well as permitting the possession of small amounts for recreational use.

When they think about the idea of professional athletes being permitted to use marijuana, it's easy for most people minds to race to an image of players hanging out, rolling joints, breaking out the bongs or gas masks, and toking up. While that surely happens in instances of both medical and recreational use, it is not what Kerr is talking about. Nor is it really what medical marijuana is about.

The FDA has not approved marijuana as a safe and effective drug for any indication. The agency has, however, approved two drugs containing a synthetic version of a substance that is present in the marijuana plant and one other drug containing a synthetic substance that acts similarly to compounds from marijuana but is not present in marijuana. Although the FDA has not approved any drug product containing or derived from botanical marijuana, the FDA is aware that there is considerable interest in its use to attempt to treat a number of medical conditions, including, for example, glaucoma, AIDS wasting syndrome, neuropathic pain, cancer, multiple sclerosis, chemotherapy- induced nausea, and certain seizure disorders.

Essentially, the FDA has approved two medications that can get cannabinoids into a person's system by swallowing a pill. One is for THC, which increases appetite and decreases nausea, and may also reduce pain, inflammation, and muscle control issues. Another is for CBD, which can decrease pain and inflammation, and also has been used to treat mental health issues and addiction disorders.

These benefits are at the heart of what Kerr is after when it comes to marijuana for pain management. But that is not all he is concerned with on the subject. According to his own experience and research, he thinks that managing pain by dosing players with Vicodin, Oxycontin, Percocet, and the like to happens too much and too often harms their long-term health. Why, he wonders, is there is not the same public stigma for use of those drugs as there is for marijuana?

Kerr holds up marijuana as an option, not the answer. Physicians and medical professionals usually take the same tack, recommending it to patients after other treatments have come up short. As of the moment, 28 states and the District of Columbia permit the use of medical marijuana. That covers a number of cities with NBA, NFL, MLB, NHL, and many other major league franchises.

A customer is attended to inside the Herbal Remedies cannabis store on November 9, 2016, just outside the Salem, Ore., city line. (Photo credit: Andrew Selsky/AP)

Opponents of permitting medicinal use in the NBA and other leagues will try to blur the line between marijuana of the medicinal type and of the recreational variety. But there shouldn't be any confusion about marijuana administered to patients with a prescription under physician supervision.

Pain management for professional athletes is serious business. The NBA, especially under the leadership of Commissioner Adam Silver, is a league that has been at the forefront of moving the country forward on tough issues. Kerr's comments about medical marijuana have now put the issue front and center.

Pain management in pro sports has relied on drugs that can be truly dangerous. It is time for a change. If medical marijuana is good enough for the majority of states to allow, it is time for the NBA to take the lead in sports and make that option permissible to players, coaches, doctors, and staff.

Arthur L. Caplan, PhD, is the Drs. William F. and Virginia Connolly Mitty Professor and head of the Division of Bioethics at the New York University School of Medicine. Lee H. Igel, PhD, is associate professor in the Tisch Institute at New York University. Both are affiliated with the NYU Sports and Society program.